CMS Limits Part D Prior Authorization for Hospice Patients

August 1, 2014 | Aging Services Risk, Quality, & Safety Guidance

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​In recognition of the operational challenges posed by its requirement for prior authorization for all Medicare Part D prescriptions for hospice patients, the Centers for Medicare and Medicaid Services (CMS) announced on July 18, 2014, that it will limit prior authorization requirements to analgesics, antinauseants, laxatives, and antianxiety drugs. Because the Medicare hospice benefit is a single per-diem all-inclusive payment per beneficiary, CMS's initial prior authorization rule was intended to ensure that drugs were billed correctly when Medicare Part D reimbursement was sought.

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